The Impact of Long Term Conditions Flashcards
What is meant by the concept of person centred care?
Person-centred care is the provision of care that places the patient at the centre ensuring that the healthcare system is designed to meet the needs and preferences of patients as defined by patients themselves
What are the 5 principles of patient centred healthcare?
- Respect.
- Choice and empowerment.
- Patient involvement in health policy.
- Access and support.
- Information.
What is the WHO definition of disability?
1) Body & Structure Impairement (organ level)
2) Activity Limitation (personal level)
3) Participation Restrictions (social & environmental level)
What are some examples of medical models of disability?
1) Personal cause - e.g. injury whilst drunk
2) Underlying pathology - e.g. obesity
What are some examples of social models of disability?
1) Low wages
2) Housing problems
3) Political action needed - e.g. new facilities
What are the current trends in long term conditions?
- Acute illnesses are becoming less common
- Long term conditions are becoming increasingly prevalent
- Long term conditions are more common in older people and in more deprived groups
- Long term conditons account for:
1) 50% of GP appointments
What are the different courses and severity of long-term conditions?
Acute onset - Stroke or MI
Gradual onset - Angina
Relapse & remission - Cancer
What is the broad impact that long term conditions can have on individuals?
Long-term conditions can impact:
1) The individual - denial, self pity and apathy
2) The family - emotional
3) Community - isolation of individuals
How does health vary geographically within Scotland?
Good or Very good health - NE Scotland
Bad or Very Bad Health - SW Scotland, Glasgow
What is meant by ‘The Burden of Treatment’? and ‘Biographical Disruption’?
The Burden of Treatment - The enormous demands put on patients and caregivers by the healthcare system, e.g. behaviour changes, managing symptoms at home, Complex treatment regimens
Biographical Disruption - When a long term condition leads to a loss of confidence in the body, which leads to a loss of confidence in social interaction or self-identity
What are the multiple factors that influence symptoms, chronicity and disability?
Genetic factors
Environmental factors
Mixture of both
Patients vulnerability - patients capacity to resist disease & repair damage
Alcohol
Obesity
Mental illness
What are the range of individuals responses to long term conditions and the reasons for these?
The range of responses to long term conditions/disabilities depends on many factors:
1) Nature of the disability
2) Education and intelligence levels of the individual
3) Personality of the individual
4) Mood and emotional reaction of the individual
5) Reaction of others around them
6) Support network of the individual
How can the acceptance of failure in diagnosis or cure result in better management and outcomes?
Understanding that the initial diagnosis was incorrect sooner rather than later will result in better management and outcomes for the patient and doctor
What is the sick role and what are its implications for patients and doctors?
The sick role is an attitude/position the patient adopts in order to fit with the socially accepted rights and obligations of those with an illness
By playing the sick role, the patient could enjoy certain ‘benefits’:
- Being exempt from social, financial & familial responsibilities
- Being addicted to their medications
By adopting the sick role, the patient may hinder their recovery
What are some measures that prevent activity limitation?
1) Rehabilitation
2) Multi-disciplinary team approach to preventing activity limitation
3) Disability Discrimination Acts
4) Equality act
What are Wilson’s criteria for screening?
1) Knowledge of Disease
2) Knowledge of the test/examination
3) Treatment for the disease
4) Cost of the test/examination and treatment
What are some issues that may be raised by screening?
Finding a condition that cannot be treated or do not know how to treat
Financial implications of uncovering lots of new disease cases
Are the treatment facilities available
What is the epidemiology of activity limitation?
Injury
Congenital
Alcohol
Mental Illness
Obesity
What are some of the negative attitudes towards activity limitation that can affect integration & rehab?
1) Stigamitising those with long term conditions
A patient has been discharged from hospital following a major heart attack. Previously they were in good health.
What issues do you have to manage?
Are there only medical issues? Or might there be personal or psychological issues too?
How does this situation differ to a patient who has a slow onset chronic illness (e.g. COPD)?
Issues to manage - Preventative treatment, patient recovery, patient education
Personal or psychological issues - Stress of healthy person suffering an acute attack of illness, feeling of ‘loosing’ health, anxiety about having another attack, worries about returning to work, worries about family life and responsibilities, financial worries
Comparing to a patient with a slow onset chronic disease - Patients can gradually adapt to slow onset diseases, patients with acute attacks of illness may struggle to adapt and come to terms with their illness
What is meant by the concept of the expert patient and how can it be used as a positive?
- A patient who has become an expert in their condition, sometimes more of an expert than that of health professionals
- Their extensive knowledge could greatly benefit the quality of the patients care and quality of life
- The knowledge and experience held by the patient has been an under-utilised resource
